The overall goal of the Mayo Clinic CTSA is to continue to build a broad-based and integrated home for clinical and translational science (CTS) at Mayo Clinic that will ultimately improve human health. In this context, we seek to make the Mayo CTSA and the resources it leverages both an engine of efficiency for clinical and translational research and at the same time a driver of innovation. We also seek to integrate our local activities with consortium wide efforts directed at coordination and alignment. To achieve our goal we have six overarching specific aims for this renewal: Aim 1 - Train and maintain an outstanding multidisciplinary clinical and translational sciences workforce. This workforce includes teams of both investigators and support staff. Aim 2 - Eliminate barriers to the work of translation. This will be accomplished through a) continued efforts at regulatory and compliance streamlining, b) provision of outstanding design, biostatistics, and ethics support for investigators, and c) further integration of support services. Aim 3 - Collaborate with providers and communities to improve health care delivery and community health. This includes substantial commitments to practice-based research, communityengaged research and translating comparative effectiveness research into clinical practice. Aim 4 - Deploy advanced facilities and other core resources to increase the value of clinical research. With value defined in this context as the quotient of quality and cost, the goal is to increase quality, decrease costs, and provide resources to the full spectrum of clinical and translational investigation. Aim 5 - Stimulate novel research directions and methodologies by targeted support of innovative pilot and feasibility studies and fostering the development of novel methodologies. Aim 6 - Employ informatics to integrate and facilitate clinical and translational investigation. This encompasses a broad view of informatics including: a) developing a standardized electronic data capture and analysis tools for CTS, b) robust consultation and tools for medical informatics that leverage Mayo's commitments to electronic clinical systems, and c) bioinformatics services and capabilities that will help facilitate the application of the "new biology" to clinical and translational investigation. This vision is entirely consistent with the stated mission of Mayo Clinic: "To provide the best care to every patient every day through integrated clinical practice, education, and research."